脳磁図の臨床応用に関する文献レビュー (第6報) : 神経変性・脱髄疾患と神経リハビリテーション  [in Japanese] Bibliographic survey on the clinical application of magnetoencephalography (VI): Neurodegenerative or demyelinating disease and neurorehabilitation  [in Japanese]

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Abstract

脳磁図の科学的エビデンスは, てんかん以外の疾患において明らかでない。本研究では文献検索に基づき神経内科疾患と神経リハビリテーションの脳磁図臨床研究の動向を調べることを目的とした。MEDLINE にて (amyotrophic lateral sclerosisなど個々の対象疾患名) AND (MEG OR magnetoencephalography) を検索して2011年11月までに発表された論文を抽出した。この中から原著論文をえらび, エビデンスレベル, 抄録内容に基づいて, 神経内科疾患ではALS 3編, Parkinson病8編, 多発性硬化症4編について概要をまとめた。神経リハビリテーションについては虚血性脳血管障害からの回復に関わる研究に焦点を絞り, 運動感覚障害9編, 失語症3編について概要をまとめた。27編のうち診断・治療方針の決定に関するエビデンスレベルはグレード1: 0編, 2: 18編, 3: 3編, 4: 6編, 5: 0編, 6: 0編であった。脳磁図は局所の自発活動を非侵襲的に計測できることから, 少数症例の検討ながら, 複数の領域間の機能的連絡あるいは視床下核などの深部組織の活動と脳局所のコヒーレンスなど, 疾患や回復過程に伴う脳機能変化や疾患固有の病態生理を理解する上で新しい知見をもたらすことがわかった。

The scientific evidence of magnetoencephalography (MEG) is not necessarily clear except for a diagnosis of epilepsy. In this study, we reviewed clinical MEG studies regarding neurological diseases or neurorehabilitation based on a website bibliographic survey. We searched MEG papers on neurological diseases or neurorehabilitation before November 2011 using MEDLINE by keywords: (a representative diagnosis such as amyotrophic lateral sclerosis, ALS) AND (MEG OR magnetoencephalography). Among many papers retrieved, we further narrowed the search to 27 papers based on levels of evidence and abstract contents; as to neurological diseases, 3 papers on ALS, 8 papers on Parkinson disease and 4 papers on multiple sclerosis were reviewed: and as to neurorehabilitation, 9 papers on recovery from sensorimotor deficits and 3 papers on recovery from aphasia due to an ischemic stroke. The levels of evidence were classified as grade 1: no paper, 2: 18 papers, 3: 3 papers, 4: 6 papers, 5: no paper, 6: no paper, respectively. Most studies were confined to small number of patients. However, MEG has an advantage of detecting spontaneous activity in a small brain region and providing functional network activity between multiple brain areas or coherent activity between deep brain nuclei and distinct cortical areas. Therefore, the MEG tells us functional changes in a certain disease or a recovery phase from an ischemic stroke, and gives a novel insight into disease-specific pathophysiology such as Parkinson disease.

Journal

  • Japanese Journal of Clinical Neurophysiology

    Japanese Journal of Clinical Neurophysiology 41(2), 57-70, 2013

    Japanese Society of Clinical Neurophysiology

Codes

  • NII Article ID (NAID)
    130005003306
  • Text Lang
    JPN
  • ISSN
    1345-7101
  • Data Source
    J-STAGE 
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